📃 Paper Title: Conservative management of staghorn calculi: a single-centre experience
🧍 Author: Deutsch
🕒 Year: 2016
📚 Journal: BJUI
🌎 Country: UK
ㅤContext to the study:
What is a paper that supports the conservative management of staghorn stones in unfit patients?
ㅤ✅ Take-home message of study:
The conservative approach to treating staghorn calculi, especially in patients who are medically unfit for surgery or choose not to undergo intervention, can be a viable and successful option when patients are carefully selected.
This approach necessitates consistent monitoring of infection and renal function, along with the use of appropriate antimicrobial prophylaxis and conservative surgical interventions as necessary.
ㅤ Prospective cohort study
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Study participants:
22 patients with unilateral or bilateral staghorn calculi
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Key study outcomes:
Reasons for conservative management in the cohort were comorbidities (59%), patient choice (36%) or poor access/anatomy (5%)
Key outcomes:
recurrent UTIs was 50%
progressive renal failure rate was 14%
disease-specific mortality rate was 9%
dialysis-dependence rate was 9%
rate of hospital attendances attributable to stone-related morbidity was 27%
Bilateral staghorn stones had worse disease-specific mortality (0 vs 40%) and morbidity (12 vs 80%)
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Study Limitations:
Small sample size, short follow-up
Retrospective design - potential for selection bias and incomplete data.
Single center experience + Lack of a control group
More data are needed to help relatively symptom-free patients to make informed decisions regarding conservative management.
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